Symptom. I. Stage of Incubation. The usual duration of the period which intervenes between the reception of the infection of variola and its initiatory development is from twelve to fourteen days. This has been called by nurses the period in which the disease is breeding. In some instances, children, and older persons as well, are sensibly affected, and experience a very considerable degree of languor and lassitude during this period; in others no particular inconvenience is perceived.
II. The Stage of Development and Maturation. The first part of this period is occupied by the initiatory or eruptive fever. And as it is important to determine, if possible, the onset of this disorder, even before the eruption makes its appearance, we will endeavor to portray this fever in such a manner that it may be recognized, even in cases of children too young to speak of the intense, unusual and long continued pain in the back, which in older persons at once excited suspicion of this disease. There are three strongly-marked symptoms which precede and accompany the eruptive fever of small-pox in children, and by means of which we think the disease may always be strongly suspected and if not absolutely determined in advance of the eruption. And these are the vomiting, the coma, and the convulsions. The sickness with which the eruptive fever of small- pox sets ion is in general very severe, and the disorder of the stomach often continues for forty-eight hours, during which time vomiting frequently recurs. The cerebral condition is often one rather of stupor than of delirium; although in milder cases this latter symptom prevails. In the severer cases convulsions sometimes take place and continue, alternating with coma, for a long a period as twenty-four or thirty-six hours. The persistence of the vomiting will readily distinguish the case from scarlet fever. Nor is the skin so hot and dry as in scarlet fever. The stupor or coma, in connection with the vomiting on the one side and the convulsions of the other, will serve to enable the practitioner to distinguish the case from one of incipient cerebral affection; in which indeed there may be even prolonged vomiting, but in which neither the coma nor the convulsions are so rapidly developed.
The second part of the period of development of variola is occupied by the appearance of the papular eruption. This never occurs in less than forty-eight hours from the commencement of the actual illness; and it may be delayed somewhat longer. These papulae are at first slightly red, somewhat acuminated elevations, quite minute, and capable of being overlooked in a hasty examination; and yet conveying a distinct sense of irregularity to the finger as passes over them. “They increase in size, and in he course of forty-eight hours assume a vesicular character, and contain in whey-like fluid; while instead of a conical form they now present a central depression. During another period of forty-eight hours, or thereabouts, these vesicles go on enlarging, their central depression grows more and more apparent, and their contents become white and opaque; they are no longer vesicles, but have become converted into pustules, each of which, if they be distinct, has an areola a red hue around its base. As the size of the pustules increases they lose the central depression which they had presented while vesicles, they assume a spheroidal form, and even become slightly conical. The next change observable in them is an alteration of their color form a white to a dirty-yellow tint, which they continue to retain until the desiccation of the eruption commences. The maturation of the pustules usually occupied from the commencement of the fifth to the commencement of the eighth day of the eruption, or from the eighth to the eleventh day of the disease, when the process of desiccation begins. When the scab falls off, which it does in from three to five or six days, the skin appears stained of a reddish-brown color, which often does not disappear for several weeks; but it cases where the pustule has gone so deep as to destroy a portion of the true skin, the permanent disfiguration, the so-called pitting of the small-pox, is produced. West.
Treatment. Homoeopathy robs this disease of much of its danger. Keep the patient in a comfortable temperature, with plenty of fresh air. Among the many methods proposed for treating small- pox with medicines, I will state my own, with which, after very considerable experience, I have found no reason to be dissatisfied. In the first stage of the disorder I administer Aconite, Bryonia, Stramonium, Rhus, or Phosphorus, as the symptoms indicate in each particular case, till the eruption is out and the fever gone. Then I give a single dose of Thuya 1000, and by the time the pustules would ordinarily be filed, they will under the influence of this remedy, be all dry and scaling off.
VARICELLA CHICKEN-POX
Varicella, or chicken-pox, is a mild, febrile, vesicular eruption. This affection seems to bear a similar relation, though in a far less degree, to varioloid, that this latter eruption does to variola itself. If varioloid be taken for a bastard or spurious form of variola, then varicella may be considered a bastard or spurious form of varioloid; but with this difference, (and this is the very thing which proves its hybrid nature), varicella is alike incapable of producing either variola or varioloid, or of propagating itself.
Varicella occurs much more frequently in those who have been vaccinated, than in others; but its symptoms differ materially in different cases; in some the vesicles desiccate early, the scabs leaving no cicatrices; while in other cases the vesicles are more or less fully maturated, the scabs adhere for a longer time, and leave indelible pits in the skin when they finally fall of. Still while this disease has been thee occasion of much dispute among medical men, as to its relation to natural and to modified small- pox, its treatment with Homoeopathic medicines is at once simple and very successful. Study the following remedies.
Aconite. When much fever prevails.
Belladonna If there be very face and eyes; headache, &c.
Coffea. Very much restlessness and sleeplessness.
Mercurius. Salivation; some thirst. The water blotches turn yellow and mature.
Rhus. The eruption assumes the form of spreading blisters.
Sulphur. The pocks do not heal, they are inclined to itch and to ulcerate. Hartman recommends this medicine, with reference to the local symptoms.
Tartar e. The eruption fails to appear, and convulsions complicate the case.
Belladonna, Sepia, Dulcamara, and Clematis, should be carefully studied.
Mercurius, Sulphur, Hepar, Graphites, Calcarea, and Sepia, should be carefully compared, in cases that degenerate and where the bullae change to ulcers.
VACCINATION.
The following is the method we find most convenient to employ. Scarify the cuticle very carefully with a lancet, till the skin shows a little bloody exudation. Then apply a drop of the (solution of) virus, and promote its coming in contact with the raw surface. On the third or fourth day, when a small rose- colored spot may be seen, a minute kernel may be felt by carefully applying the finger. Now is the best time to administer the Sulphur, and await the result. Should the virus develop latent psora, Silicea will usually set all right. Psorinum may be needed, or even some other remedy, according to the symptoms present.
The first vaccination should be performed as early as the fourth week after birth. In general, it is safer to vaccinate again in the seventh year, and twice afterwards.
This is a true prophylactic. As soon as it is evident that the system responds to the action of the virus, by producing a small red point, it is best to give Sulphur 200.
In bad effects which may arise from vaccination, these will occur in some constitutions even after the use of sound virus, we resort usually to Sulphur, Silicea, or Psorinum.
DISEASES OF CHILDREN continued
ERYSIPELAS.
INFANTILE ERYSIPELAS is said to be of very unfrequent occurrence in this country; its appearance when it does occur is usually only a few days after birth, in which case it may its take its rise in umbilical phlebitis. Sometimes also it is congenital, of intra-uterine origin. In either case this disorder must be regarded as very dangerous; and by the old school it is set down as almost invariably fatal, even when arising so late as the fourth month. Symptoms. The erysipelas may be preceded by fever and other symptoms of constitutional disturbance; but in most cases the first evidence of the peculiar disorder appears in a certain suspicious redness, which commencing upon the pubis, or about the umbilicus, gradually spreads over the abdomen and thighs; the parts occupied by the inflammation being swollen, hard, and extremely tender to the touch, as indicated by the movements and cries of the child, who can scarcely bear to be touched; (Lachesis). After twenty-four hours a few scattered vesicles make their appearance upon the inflamed surface, with inflamed livid bases, which rapidly terminate in gangrenous ulcerations. “When the redness extends to the hands and feet, these parts acquire a degree of redness and swelling far greater than that on any other part. The genital organs in some cases sphacelate, in consequence of the local inflammation, and in many acquire an emphysematous appearance. In place of appearing upon the pubes first, the erysipelas has been known to extend form the areola of the vaccine vesicle; less frequently
